Robot-Assisted Partial Nephrectomy for Multiple Allograft Renal Cell Carcinomas: A Case Report.

Transplantation proceedings Pub Date : 2024-11-01 Epub Date: 2024-10-28 DOI:10.1016/j.transproceed.2024.08.045
Ayane Tachiki, Kazuhiko Yoshida, Yuki Kobari, Shinsuke Mizoguchi, Ryo Minoda, Hironori Fukuda, Kouhei Unagami, Junpei Iizuka, Hideki Ishida, Toshio Takagi
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Abstract

Background: Partial nephrectomy (PN) is strongly recommended as nephron-sparing surgery for T1 renal tumors. Although there have been some reports of robot-assisted PN (RAPN) for solitary allograft renal tumors, only a few cases of RAPN for multifocal allograft renal tumors have been reported. Herein, we report a case of a patient who underwent RAPN for multifocal allograft renal cell carcinoma (RCCs).

Case presentation: A 77-year-old male was diagnosed with 24- and 15-mm lesions in the middle portion of a right iliac fossa renal allograft. RAPN was performed using a transperitoneal approach 22 years after the kidney transplantation. The allograft renal artery was clamped, and the tumors were resected. Pathological examination revealed clear-cell RCC with negative surgical margins. There were no perioperative complications, and kidney function did not significantly change during surgery.

Conclusion: RAPN is a feasible and effective treatment option for multiple allograft RCCs. The successful preservation of renal function coupled with minimal perioperative complications underscores the potential of RAPN. Our observations suggest that RAPN can be safely implemented in similar high-risk cases, offering a nephron-sparing alternative that might extend quality of life and reduce the need for dialysis in transplant recipients.

机器人辅助肾部分切除术治疗多发性同种异体肾细胞癌:病例报告。
背景:强烈建议将肾部分切除术(PN)作为T1肾肿瘤的保肾手术。虽然已有一些关于机器人辅助肾部分切除术(RAPN)治疗单发异体肾肿瘤的报道,但关于机器人辅助肾部分切除术治疗多灶异体肾肿瘤的报道却寥寥无几。在此,我们报告了一例接受 RAPN 治疗多灶异位移植肾细胞癌(RCC)的患者:病例介绍:一名 77 岁的男性被诊断为右髂窝肾脏同种异体中间部分有 24 毫米和 15 毫米的病变。肾移植 22 年后,采用经腹膜入路进行了 RAPN 手术。夹闭了异体肾动脉,切除了肿瘤。病理检查显示为透明细胞型 RCC,手术切缘阴性。围手术期无并发症,术中肾功能无明显变化:结论:RAPN是治疗多发性同种异体RCC的一种可行而有效的方法。结论:RAPN 是治疗多发性同种异体 RCC 的可行而有效的方法,它成功地保留了肾功能,且围术期并发症极少,这凸显了 RAPN 的潜力。我们的观察结果表明,RAPN 可以安全地应用于类似的高风险病例,提供了一种保留肾脏的替代方案,可以延长移植受者的生活质量并减少透析需求。
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